Mental Stress and Myocardial Ischemia After MI: Sex Differences, Mechanisms and Prognosis

The purpose of this study is to look at the link between emotional stress and heart disease in men and women. Taking part in this study involves one clinic visit, one week of at home monitoring, and follow up phone calls every 6 months for 3 years.

Inclusion Criteria: * History of documented MI within the past 8 months * Age ≤60 at the time of MI Exclusion Criteria: * History of unstable angina, MI, or decompensated heart failure in the past month * Patients deemed to be unsafe to hold anti-ischemic medications before testing (it is standard protocol to hold these meds before imaging studies) * Systolic blood pressure (SBP) \>180 mm Hg or diastolic blood pressure (DBP) \>110 mm Hg on the day of the test * Alcohol or substance abuse (past year), or severe psychiatric disorder other than major depression * Other serious medical disorders that may interfere with the study results * Postmenopausal hormone therapy (past 3 months) * Current psychotropic medications (past month) except anti-depressants * Pregnancy or breastfeeding (all women will receive a pregnancy test) * Severe aortic stenosis * Weight ≥ 360 pounds and/or body mass index (BMI) of 40 or greater (weight limit of the SPECT imaging table)